Melanomas in prepubescent children versus pubescent children in the Western Australian melanoma advisory service

Introduction: While relatively uncommon, childhood prevalence of melanoma has been well reported. Despite this the correlation between presenting characteristics and age is not well defined, leading to possible delays in diagnosis. We describe features of prepubescent compared to pubescent melanomas of patients who presented to the Western Australian Melanoma Advisory Service in the last 14 years.
Method: A retrospective review of paediatric melanoma cases was conducted from a prospectively maintained WAMAS database. Melanomas from 2000 to 2014 were identified from WAMAS and were reviewed for demographics, clinical information and histological characteristics.
Results: 25 patients were identified. Seven were between 0-12 years old (prepubescent) and 18 between 13-19 years old (pubescent). Head and neck region (n=3) and upper extremity (n=3) were the most common sites of melanoma in the prepubescent population. In the pubescent population, the most common site was the head and neck (n=6), followed by the upper back (n=5). Spitzoid melanomas predominated in the prepubescent population (n=3, 42.9%), while superficial spreading melanomas predominated in the pubescent population (n=9, 44.4%). All of the patients presented with primary invasive melanoma except one pubescent patient who had metastatic disease. Two (28.6%) prepubescent patients had a history of pre-existing naevus, compared to 8 in the pubescent population (44.4%). Two prepubescent patients (28.6%) had a Fitzpatrick skin type of 3 or less, opposed to 12 patients (66.6%) in the pubescent population.
Conclusion: Particular patient characteristics and histological features in the WAMAS patients may suggest a difference between melanomas in the prepubescent versus pubescent population.

Dr. Jie Xu